The objective of this proposal is to implement an integrated academic information management system (IAIMS) supporting administration, patient care, education, and research activities at Duke University Medical Center. The IAIMS will consist of the processes and systems necessary to: 1) manage data and information technology as a shared resource; and 2) bring together data, information, and the tools necessary to apply data and information in the decision making process, at the place time that the decision must be made. IAIMS will increase the efficiency and effectiveness of the Medical Center. IAIMS will be achieved through integration of distributed information management resources. The implementation strategy has six elements: 1) provision of core processes and technologies, 2) extension of a critical mass of IAIMS functions to all users, 3) development of demonstrations of full IAIMS function in each user domain, 4) development of new techniques of user support, 5) evaluation of system effectiveness, and 6) dissemination of information about IAIMS approaches and impact. The approach to providing IAIMS is unique because it permits retention of an institution's existing systems and utilization of purchased software modules without compromise to the overall effectiveness of the systems infrastructure. The implementation process is designed to provide generic information about approaches to implementation for transfer to other institutions.